急性呼吸窘迫综合征患者血糖变异度与酸碱平衡及预后的相关性

Correlation between blood glucose variability and acid-base balance and prognosis in patients with ARDS

目的探讨重症监护室(ICU)急性呼吸窘迫综合征(ARDS)患者血糖变异度与酸碱平衡及预后的相关性。方法选择我院ICU 2014年1月至2016年6月收治的60例ARDS患者,根据各患者住院期间测得血糖的标准差按四分位数将患者分为G_1、G_2、G_3、G_44组,比较各组之间酸碱中毒发生率、血糖均值、机械通气时间、ICU住院时间、APACHEⅡ评分、低血糖发生率、ICU死亡率,整体分析血糖标准差与酸碱平衡及预后的相关性。结果 G_1、G_2、G_3、G_44组之间性别、年龄、碱中毒发生率、血糖均值、机械通气时间、ICU住院时间、APACHEⅡ评分、低血糖发生率差异无统计学意义(P>0.05);4组之间酸中毒发生率、ICU死亡率差异有统计学意义(P<0.05),且随血糖变异度的增加,酸中毒发生率及ICU死亡率也随之增加。血糖变异度与酸中毒发生率存在显著正相关关系(rs=0.674,P<0.05);血糖变异度与碱中毒发生率无相关关系(rs=0.098,P>0.05);血糖变异度与ICU死亡率存在显著负相关关系(rs=-0.730,P<0.05)。结论血糖变异度与酸中毒发生率及预后显著相关,随着血糖变异度的增加,酸中毒发生率及ICU死亡率随之增加。

Objective To investigate the correlation between blood glucose variability and acidbase balance and prognosis in patients with acute respiratory distress syndrome（ARDS）in intensive care unit（ICU）.Methods A total of 60 cases of ARDS patients in our hospital ICU from January 2014 to June 2016 were selected,and were divided into four groups（G1,G2,G3,G4）according to the quartiles which based on the glucose standard deviation measured of the patients during the period of hospitalization.Acid-base poisoning occurrence rate,mean blood glucose,duration of mechanical ventilation and the length of stay in ICU,APACHE Ⅱ score,hypoglycemia occurrence rate,ICU mortality were compared between these four groups.The correlation between standard deviation of blood glucose and acid-base balance and prognosis was analyzed.Results There was no significant difference in gender,age,alkali poisoning occurrence rate,mean blood glucose,duration of mechanical ventilation,occupancy time in ICU,APACHE Ⅱ score,hypoglycemia incidence rate between G1,G2,G3,G4 four groups（P〉0.05）;there was significant difference in acid poisoning occurrence rate,ICU mortality between the four groups（P〈0.05）,and with the increase of blood glucose variability,acid poisoning occurrence rate and ICU mortality increased.There was significant positive correlation between blood glucose variability and the incidence of acid poisoning（rs=0.674,P〉0.05）;there was no correlation between blood glucose variability and alkali poisoning（rs=0.098,P〈0.05）;there was significant negative correlation between blood glucose variability and ICU mortality rate（rs=-0.730,P〈0.05）.Conclusion The blood glucose variability is significantly correlated with the incidence of acidosis and prognosis,with the increase of blood glucose variability,the incidence of acidosis and ICU mortality rate increases.